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FEE WORKSHLET PER EACH FACILI* 40 <br /> FACILITY <br /> DBA Andy' s Auto Repair & Gas ADDRESS 8888 E. Hwy. 12 <br /> MAILING ADDRESS <br /> I. Operating Permit Application/Annual Inspection Fee <br /> a. First Tank at Facility @ $150. 150 <br /> b. Additional Tanks (# 2 Additional Tanks x $50) 100 <br /> 2. State Surcharge (per tank) (Due with Permit Application, <br /> on renewal or amendment of operation permit and temporary closure) <br /> ($56 x Total # 3 Tanks) <br /> lb8 <br /> �K *Temporary Closure (per tank) Underground Storage Tank in which <br /> storage has ceased but where the owner/operator proposes to <br /> re-use tank within 2 years. <br /> (# Temporary closures x $80) (See above #3 to calculate surcharge) <br /> 4. *Permanent Closure (per tank) underground Storage Tank in which <br /> storage has ceased and where the owner/operator has no intent <br /> of re-using tank . <br /> (# Permanent Closures x $90) <br /> V. Plan Check Fee $30. <br /> Total Number of Tanks 3 Total Fee Due ' 418 <br /> X73 <br /> Make all fees payable to San Joaquin Local Health District. Enclose this worksheet <br /> with your check . <br /> EXAMPLE - Annual Fee for Facility with 4 Tanks <br /> ( 1 regular, I unleaded, I supreme, I waste oil ) <br /> Ia. Existing Facility & Ist Tank $150 <br /> b. 3 Additional Tanks x $50 150 <br /> 2. State Surcharge, 4 Tanks x $56 224 <br /> Total Number of Tanks 4 Total Fee Due $524 <br /> *Both closures will be conditioned. Contact a Health District Re resentative. <br /> 2-86 <br /> 0 0,- f <br />